Relapses Rates and Patterns for Pathological T0 After Robot-Assisted Radical Cystectomy: Results From the International Robotic Cystectomy Consortium

Ahmed S. Elsayed, Umar Iqbal, Zhe Jing, Holly A. Houenstein, Carl Wijburg, Peter Wiklund, Eric Kim, Michael Stöckle, John Kelly, Prokar Dasgupta, Andrew A. Wagner, Jihad Kaouk, Ketan K. Badani, Juan Palou Redorta, Alexandre Mottrie, James O. Peabody, Morgan Rouprêt, Derya Balbay, Lee Richstone, Koon Ho RhaAhmed Aboumohamed, Qiang Li, Ahmed A. Hussein, Khurshid A. Guru

Research output: Contribution to journalArticlepeer-review


Objectives: To investigate the oncologic outcomes of pT0 after robot-assisted radical cystectomy (RARC). Methods: A retrospective review of the International Robotic Cystectomy Consortium database was performed. Patients with pT0 after RARC were identified and analyzed. Data were reviewed for demographics and pathologic outcomes. Kaplan-Meier curves were used to depict recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS). Multivariate stepwise Cox regression models were used to identify variables associated with RFS and OS. Results: Four hundred seventy-one patients (18%) with pT0 were identified. Median age was 68 years (interquartile range (IQR) 60-73), with a median follow up of 20 months (IQR 6-47). Thirty-seven percent received neoadjuvant chemotherapy and 5% had pN+ disease. Seven percent of patients experienced disease relapse; 3% had local and 5% had distant recurrence. Most common sites of local and distant recurrences were pelvis (1%) and lungs (2%). Five-year RFS, DSS, and OS were 88%, 93%, and 79%, respectively. Age (hazards ratio [HR] 1.05, 95% confidence interval [CI] 1.01-1.09, P = 0.02), pN+ve (HR 11.48, 95% CI 4.47-29.49, P < .01), and reoperations within 30 days (HR 5.53, 95% CI 2.08-14.64, P < .01) were associated with RFS. Chronic kidney disease (HR 3.24, 95% CI 1.45-7.23, P < .01), neoadjuvant chemotherapy (HR 0.41, 95% CI 0.18-0.92, P = .03), pN+ve (HR 4.37, 95% CI 1.46-13.06, P < .01), and reoperations within 30 days (HR 2.64, 95% CI, 1.08-6.43, P = .03) were associated with OS. Conclusions: Despite pT0 status at RARC, 5% had pN+ disease and 7% of patients relapsed. Node status was the variable strongest associated with RFS and OS in pT0.

Original languageEnglish
Pages (from-to)177-181
Number of pages5
Publication statusPublished - 2022 Aug

Bibliographical note

Funding Information:
Financial Disclosure: The authors declare no conflicts of interest. The study was a retrospective review of Institutional Review Board approved (I-79606) departmental database. Funding Support: Roswell Park Alliance Foundation.

Publisher Copyright:
© 2022

All Science Journal Classification (ASJC) codes

  • Urology


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